Thorac Cardiovasc Surg 2016; 64 - OP119
DOI: 10.1055/s-0036-1571570

Anticoagulative Treatment in LVAD Patients: Telemonitoring by Use of Vitaphone®

S. Eifert 1, A. Meyer 2, S. Lehmann 2, J. Fischer 2, A. Oberbach 2, E. Langenstroth 2, F. W. Mohr 2, J. Garbade 2
  • 1Ludwig-Maximilians-Universität München, Cardiac Surgery, Munich, Germany
  • 2Heart Centre, University of Leipzig, Cardiac Surgery, Leipzig, Germany

Objective: Optimal anticoagulative treatment is essential for the outcome and frequency of thromboembolic events of patients on left ventricular assist device (LVAD). Supervision of anticoagulative treatment may be difficult in these cases.

Methods: We want to report our results of telemonitoring by use of Vitaphone in 50 out 176 ambulatory LVAD patients. INR range was set between 1.9 to 2,7.

Results: Fifty patients on LVAD (46 men, 4 women) were telemonitored over a median duration of 178 ± 118 days. INR measurements were performed every 7 ± 9 days. Median number of INR measurements was 27 ± 32 over the entire time of the study. Vitaphone telemonitoring did detect a median frequency of absolute outliers of 6 ± 6 per patient. The percentage of wrong INR values was demonstrated in a percentage of 18,18 ± 16,1 of patients.

Six of 50 patients did never have wrong INR levels. The lowest measured INR was 1,4 and the highest 5,6 in one patient each.

Twenty seven of 50 patients did never drop below INR of 1,9. The lowest median INR of our study cohort measured 1,9 ± 0,18. Two of the included patients showed and LVAD thrombus and underwent successful thrombolysis. Thirty seven patients exceeded our set upper INR level of 2.7. The highest median of INR was 3,1 ± 0,64. INR outliers received immediate modulated anticoagulative drugs.

Conclusions: Telemonitoring anticoagulation in LVAD patients is a novel, feasible and supportive measure to reach optimal therapeutic INR levels for this specificheart failure cohort.